140 articles - From Friday Mar 08 2024 to Friday Mar 15 2024
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Gastroenterology |
|---|
AGA Clinical Practice Update on Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Commentary. Methods This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology. This expert commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors. |
meta-analyses and systematic reviews
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Oral vancomycin is associated with improved inflammatory bowel disease clinical outcomes in primary sclerosing cholangitis-associated inflammatory bowel disease (PSC-IBD): A matched analysis from the Paediatric PSC Consortium. Vancomycin was associated with greater odds of IBD clinical and endoscopic remission. Additional, preferably randomised, controlled studies are needed to characterise efficacy using objective markers of mucosal inflammation, and to examine safety and define optimal dosing. |
Prevalence and risk factors of metabolic dysfunction-associated steatotic liver disease in south Central Uganda: A cross-sectional survey. In a relatively young cohort in Uganda, 14% of women and 8% of men had MASLD. There was an indication of an association between HIV and MASLD in multivariable analysis. These data are the first to describe the population-level burden of MASLD in sub-Saharan Africa using data from a population-based cohort. |
Short-term reduction of dietary gluten improves metabolic-dysfunction associated steatotic liver disease: A randomised, controlled proof-of-concept study. A short-term ATI-free diet leads to significant improvements in liver and metabolic parameters, as well as patient-reported outcomes with good tolerability. A larger follow-up study is justified to corroborate these findings. Clinical trial number NCT04066400. |
Von Willebrand factor for outcome prediction within different clinical stages of advanced chronic liver disease. VWF is the only biomarker that gradually increases across al ACLD stages. It is of particular prognostic value in cACLD, where a CRP/VWF-based model is equivalent to an invasive HVPG-based model. Systematic differences in VWF underline the importance of interlaboratory surveys. Moreover, our findings reinforce the notion that, already in cACLD, inflammation is a key disease-driving mechanism. |
| Am J Gastroenterol |
A MINORITY OF CHILDHOOD DISORDERS OF GUT-BRAIN INTERACTION PERSIST INTO ADULTHOOD: A RISK-FACTOR ANALYSIS. Childhood DGBI persist into adulthood in 10-20% of patients, suggesting that management monitoring should continue into adulthood. Those diagnosed with anxiety or mood disorders in childhood should receive particular attention and prescription of NSAIDs in children should be made judiciously. |
Diagnostic efficacy of a novel rotating brush for endoscopic sampling of malignant biliary strictures: a multicenter prospective study. The RIS brush was a promising tool for effective and safe MBSs sampling and diagnosis. Further randomized studies are warranted to confirm our results. (Chictr.org.cn, identifier ChiCTR2100047270). |
Food Insecurity, Low Household Income, and Low Education Level Increase the Risk of Having Metabolic Dysfunction Associated Fatty Liver Disease (MASLD) Among Adolescents in the United States. Food insecurity is associated with MASLD among U.S. low-income adolescents especially Hispanic males with obesity and hypertension. Policies addressing inequities are needed. |
Impact of Human Immunodeficiency Virus Infection on Liver and Cardiovascular Outcomes in Veterans with Metabolic Dysfunction Associated Steatotic Liver Disease. Among U.S. Veterans with MASLD, concurrent HIV infection, and particularly not being on ART, is associated with greater risks CVD and decreased overall survival. No differences in risks of cirrhosis or HCC were observed. |
Limited sustained remission after nucleos(t)ide analogue withdrawal: Results from a large, global, multi-ethnic cohort of patients with chronic hepatitis B (RETRACT-B study). Despite allowing for HBV DNA and ALT fluctuations within the first 12 months off-treatment, most patients without HBsAg loss did not maintain a sustained response thereafter. The best candidates for NA withdrawal are patients with low HBsAg levels at NA cessation, and those without profound or recurrent virological and biochemical relapses in the first off-treatment year. |
Non-Hispanic Black persons with nonalcoholic fatty liver disease have lower rates of advanced fibrosis, cirrhosis, and liver-related events even after controlling for clinical risk factors and PNPLA3 genotype. The risk of advanced fibrosis in NHB with NAFLD is significantly lower, after controlling for clinical risk factors and PNPLA3 genotype. Although their risk for advanced fibrosis was low, NHB with NAFLD and advanced fibrosis had higher NAS and lobular inflammation, indicating a difference in their relationship between necroinflammation and fibrosis. |
The Role of Hospital Characteristics in Clinical and Quality Outcomes for Gastrointestinal Bleeding in a National Cohort. Patients hospitalized for GIB at hospitals with multiple advanced specialized capabilities have lower mortality but longer lengths of stay. Further research should examine the processes of care linked to these services that contribute to improved mortality in GIB. |
| Endosc Int Open |
A comprehensive examination of small-bowel capsule endoscopy in Spanish centers to meet European Society of Gastrointestinal Endoscopy standards. Our results show that the minimum standard is hardly reached in most procedures, which calls into question their clinical applicability in real life. We suggest performing similar studies in other countries to evaluate whether there is a need for quality improvement programs or a need to reevaluate the minimum and target values published so far. |
Characteristic endoscopic findings in early-stage autoimmune gastritis. Endoscopic findings characteristic of early-stage AIG include a bamboo joint-like appearance and a salmon roe-like appearance. Studies in large numbers of patients with long-term follow-up are needed to confirm these findings. |
Comparison of endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy to generate pancreatic cancer organoids: Randomized trial. EUS-FNB was superior to EUS-FNA in terms of successful generation of PDOs, although it failed to show statistical significance. |
Incidence and factors associated with stent dysfunction and pancreatitis after gastroduodenal stenting for malignant gastric outlet obstruction. Deployment of the Niti-S pyloric/duodenal stent, with conformability even for angulated strictures, significantly reduced the incidence of SD. Stent selection, life expectancy, and MPD caliber should be taken into consideration during decision-making for GDS deployment for mGOO. |
The professional background of a referring physician predicts the diagnostic yield of small bowel capsule endoscopy in suspected small bowel bleeding. The professional background of referring physicians significantly improves the diagnostic yield of SBCE and contributes to controlling public health costs. |
| Endoscopy |
Digestive neo-epithelialization after endoscopic stenting for upper digestive tract complete disunion. This case series shows that complete digestive rupture could be, in selected cases, successfully treated by endoscopy, adding proof-of-concept data regarding guided tissue regeneration alongside SEMS. |
| Gastroenterology |
Biopsy proteome scoring to determine mucosal remodeling in celiac disease. Biopsy proteome scores give reliable observer and orientation-independent measures of mucosal remodeling in CeD. The proteomic method can readily be implemented by non-expert laboratories in parallel to histology assessment and easily scaled for clinical trial settings. |
Genetic Deletion of Galectin-3 Inhibits Pancreatic Cancer Progression and Enhances the Efficacy of Immunotherapy. GAL3 promotes PDAC progression and immunosuppression via both cancer cell-intrinsic and immune-related mechanisms. Combined treatment targeting GAL3, CXCL12-CXCR4 axis, and PD-1 represents a novel therapeutic strategy for PDAC. |
Sacral neural crest-independent origin of the enteric nervous system in mouse. sNCCs do not contribute to the murine ENS, suggesting that the mammalian ENS exclusively originates from vNCCs. These results have immediate implications for comprehending (and devising treatments for) congenital ENS disorders, including Hirschsprung's disease. |
THORACOABDOMINAL WALL MOTION-GUIDED BIOFEEDBACK TREATMENT OF ABDOMINAL DISTENSION: A RANDOMIZED PLACEBO-CONTROLLED TRIAL. Abdominothoracic wall movements serve as an effective biofeedback signal for correcting abdominophrenic dyssynergia and abdominal distention in patients with disorders of the gut-brain interaction. ClincialTrials.gov number, NCT04043208. |
| Gastrointest Endosc |
Contributions of early detection and cancer prevention to colorectal cancer mortality reduction by screening colonoscopy: a validated modelling study. Reduction of CRC mortality mainly arises from early detection of prevalent cancers during the early years after screening colonoscopy, but prevention of incident cases accounts for the majority of prevented deaths in the longer run. Prevention of incident cases leads to sustained strong reduction of colorectal cancer mortality, possibly warranting an extension of screening intervals. |
Endoscopic Submucosal Dissection for Early Esophageal Adenocarcinoma: Low Rates of Metastases in Mucosal Cancers with Poor Differentiation. During long-term follow-up the risk of metastasis is low after ER of mucosal EAC with PD as single risk factor. A conservative approach seems justified in this small patient group. However, the treatment strategy has to be determined on an individualized basis until further prospective data are available. |
Initial Experience with Duodenoscopes with Single-Use End Caps in Pediatric Endoscopic Retrograde Cholangiopancreatography: Infection Prevention Comes at a Cost. We report difficulty with advancement, greater reliance on advanced cannulation techniques, and higher rates of PEP when using duodenoscopes with single-use end caps in pediatric ERCP. This area warrants further study. |
Interobserver agreement of current and new proposed endoscopic scores for postoperative recurrence in Crohn's disease. The interobserver agreement of the mRS is substantial. Similarly, the interobserver agreement is substantial for the updated Rutgeerts' score. According to the REMIND score, the interobserver agreement was substantial for lesions in the neoterminal ileum, whereas only moderate for anastomotic lesions. Since therapeutic decisions in clinical practice are based on these assessments and these scores are used as outcome measure in clinical studies, further improvement of the interobserver agreement is essential. |
The Use of a Self-Assembling Peptide Gel for Stricture Prevention in the Esophagus after Endoscopic Submucosal Dissection: A U.S. Multicenter Prospective Study. We demonstrate that SAP gel application was easy, quick, and associated with a relatively low stricture rate comparable to other prophylactic methods. Additional comparative studies are needed to corroborate these preliminary findings. |
| Gut |
Function of mast cell and bile-cholangiocarcinoma interplay in cholangiocarcinoma microenvironment. Bile HA is released from MCs through DMPD stimulation and degraded via SLC22A3 import. Different HA receptors exhibit a distinct expression profile in CCA and produce different oncogenic effects. MCs promote CCA progression in a CCA-bile interplay pattern. |
| Hepatology |
Early onset of pathological polyploidization and cellular senescence in hepatocytes lacking RAD51 creates a pro-fibrotic and pro-tumorigenic inflammatory microenvironment. Our results demonstrate a novel function of RAD51 in liver development, homeostasis and tumorigenesis. The Rad51-CKO mice represent a unique genetic model for premature liver senescence, fibrosis and hepatocellular carcinogenesis. |
Feasibility of hepatitis C elimination by screening and treatment alone in high-income countries. Current risk-based screening, and subsequent treatment, will be inadequate to achieve WHO goals. With extensive scale-up in screening, and treatment, the mortality target may be achievable, but the target for preventing new CHC cases is unlikely reachable, highlighting the importance of developing enhanced harm-reduction strategies for HCV elimination. |
Inhibition of sodium-glucose cotransporter-2 and liver-related complications in individuals with diabetes: A mendelian randomization and population-based cohort study. Both Mendelian randomizations using two European cohorts and a Korean nationwide population-based cohort study suggest that SGLT2 inhibition is associated with a lower risk of liver-related events. |
Intrahepatic immunoglobulin a complex induces polarization of cancer-associated fibroblasts to matrix phenotypes in the tumor microenvironment of hepatocellular carcinoma. Intrahepatic IgA induced polarization of HCC-CAFs into more malignant matrix phenotypes and attenuates cytotoxic T cell function. Our study highlighted their potential roles in tumor progression and immune suppression. |
Reversing malnutrition and low muscle strength with targeted enteral feeding in patients awaiting liver transplant: A randomized controlled trial. Targeted enteral feeding before LT improves HGS, anthropometry and immune function in severely malnourished cirrhotic patients. These findings provide a strong rationale for early consideration of NGF to reverse malnutrition and improve muscle strength. Appropriately powered studies should explore whether NGF can also impact clinically relevant outcomes including pre- and post-transplant mortality. |
Safety and efficacy of off-label bulevirtide monotherapy in HDV patients with decompensated Child-B cirrhosis - a real world case series. This report on off-label bulevirtide treatment in patients with decompensated HDV cirrhosis shows similar virologic and biochemical response rates as observed in compensated liver disease. Significant improvements were observed on surrogates of hepatic function and portal hypertension. However, this improvement was not seen in al patients. Controlled trials are needed to confirm safety and efficacy of bulevirtide in decompensated HDV-cirrhosis. |
| J Hepatol |
Efficacy of Stereotactic Ablative Radiotherapy in Patients with Oligometastatic Hepatocellular Carcinoma: A Phase II Study. SABR is an effective and feasible option for oligometastatic HCC, excellently controls local tumors, and improves survival without adversely affecting QOL. Clinical trial number NCT05173610. |
Endothelial POFUT1 controls injury-induced liver fibrosis by repressing fibrinogen synthesis. Endothelial POFUT1 prevents injury-induced liver fibrosis by repressing the expression of fibrinogen which function as a profibrotic paracrine signal to activate HSCs. Therapies targeting the POFUT1/NOTCH/HES1/STAT3/fibrinogen axis offer a promising strategy for the prevention and treatment of fibrotic liver diseases. |
One-year transplant-free survival following hospital discharge after ICU Admission for ACLF in the Netherlands. In this nationwide cohort study, ACLF grade at ICU admission did not independently affect 1-year transplant-free survival after hospital discharge. Instead, age, presence of malignancy and the severity of liver disease played a more prominent role in influencing transplant-free survival after hospital discharge. Impact and implications Patients with Acute-on-chronic liver failure (ACLF) often require intensive care unit (ICU) admission for organ support. In these patients' short-term mortality is high, but long-term outcomes of survivors remain unknown. Using a large nationwide cohort of ICU patients, we discovered that the severity of ACLF at ICU admission does not influence one-year transplant-free survival after hospital discharge. Instead, age, malignancy status and overall severity of liver disease are more critical factors in determining their long-term survival. |
Pkd1l1-deficiency drives biliary atresia through ciliary dysfunction in biliary epithelial cells. Pkd1l1 loss causes both laterality defects and fibro-proliferative EHBD transformation through disrupted ciliary signalling, phenocopying syndromic biliary atresia. Pkd1l1-deficient mice function as an authentic genetic model to study biliary atresia pathogenesis. Impact and implications The syndromic form of biliary atresia is characterized by fibro-obliteration of extrahepatic bile ducts and is often accompanied by laterality defects. The aetiology is unknown, but Pkd1l1 was identified as a potential genetic candidate for syndromic biliary atresia. We found that loss of the ciliary gene Pkd1l1 contributes to hepatobiliary pathology in biliary atresia, exhibited by bile duct hypertrophy, reduced biliary drainage, and liver fibrosis in Pkd1l1-deficient mice. Pkd1l1-deficient mice serve as a genetic model of biliary atresia and reveals ciliopathy as an aetiology of biliary atresia. This model will help scientists uncover new therapeutic approaches for patients with biliary atresia and validate screening for PKD1L1 variants by paediatric hepatologists for diagnostic evaluation. |
Syngeneic Murine Models with Distinct Immune Microenvironments Represent Subsets of Human Intrahepatic Cholangiocarcinoma. Syngeneic iCCA models display a tumor genotype-immune microenvironment phenotype correlation with differential responses to FDA-approved immunotherapy. This study underscores the importance of leveraging multiple preclinical models to understand immunotherapy response in different genetic subsets of human CCA. |
Validation of Baveno VII criteria and other non-invasive diagnostic algorithms for clinically significant portal hypertension in hepatitis delta. Standalone and composite NIT/ diagnostic algorithms are useful for CSPH diagnosis in HDV-cACLD patients. Thus, NIT may be applied to identify and prioritize patients with CSPH for novel antiviral treatments against CHD. Impact and implications Non-invasive tests (NIT) for clinically significant portal hypertension (CSPH) have been developed to identify compensated advanced chronic liver disease (cACLD) patients at risk for decompensation, but conflicting data has been published regarding the accuracy of liver stiffness measurement (LSM) for the staging of fibrosis in patients infected with hepatitis D virus (HDV). In our study including 51 HDV-cACLD patients, NIT, i.e., most importantly, the ANTICIPATE model based on LSM and platelet count, but also lab-based approaches, i.e., 3P/5P model and the von Willebrand factor to platelet count ratio (VITRO), and spleen stiffness measurement (SSM) yielded high AUROC for CSPH. Moreover, only patients with CSPH or high non-invasively assessed CSPH-risk were at risk for decompensation within two years, and the prognostic value of NIT was confirmed in a validation cohort. Thus, NIT should be applied and updated in yearly intervals in clinical routine to identify HDV-cACLD patients at short-term risk and may guide prioritization for novel antiviral treatment options. |
Van Gogh-like 2 is essential for the architectural patterning of the mammalian biliary tree. Planar cell polarity is a critical step in the post-specification sculpture of the bile duct and is essential for establishing normal tissue architecture. Impact and implications Human disease and mouse models have allowed us to define how the mammalian biliary lineage is specified during liver development. Once this relatively simple epithelium has formed though, how it undergoes morphogenesis to form a complex and branched structure is not clear. Similar to other branched tissues such as the liver and kidney the bile ducts use planar cell polarity signalling to coordinate cell movements; however how these biochemical signals are linked to ductular patterning remains unclear. Here we show that the core planar cell polarity protein, VANGL2 patterns how cell-cell contacts form in the mammalian bile duct and how ductular cells transmit confluent mechanical changes along the length of a duct. This work sheds light on how biological tubes are pattered across mammalian tissues (including within the liver) and will be important in how we promote ductular growth in patients where the duct is mis-patterned or poorly formed. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
Review article: Current indications and selection criteria for early liver transplantation in severe alcohol-associated hepatitis. While early liver transplantation for AH has survival benefits, many patients would not have received treatment for alcohol use disorder. An integrated approach to evaluating candidacy for early liver transplantation is needed. |
| Endosc Int Open |
| Gastroenterology |
| J Hepatol |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endosc Int Open |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
|---|
| Gut |
| J Hepatol |